Communication

Question 1

What do hand-offs afford?

Answer 1

1.The dissemination of information from one profession to another
2. An opportunity for the receiving professional to ask questions and identify concerns
3. Protects the patient from harm
4. Enables professionals to provide a high level of continuity of care

Question 2

When are patients most susceptible to an adverse event?

Answer 2

During hand-offs / transitions during perioperative period

Question 3

Why are hand-offs in the perioperative environment at enhanced risk for adverse patient events?

Answer 3

Common distractions –> patient volume in receiving unit, need for a “rapid & efficient” turnover rate, reduction of abrasion with surgeons

Question 4

To reduce the danger of any impact to patient safety, what do organizations do regarding hand-offs?

Answer 4

Follow a standardized method for hand-off communication

Question 5

SBAR

Answer 5

Hands off method that stands for Situation, Background, Assessment, Recommendation

Question 6

SBAR - Situation

Answer 6

What is the problem with the patient

Ex: Demographics, problem, patient stability

Question 7

SBAR - Background

Answer 7

Patient’s relevant clinical background

Ex: Patient presentation

Question 8

SBAR - Assessment

Answer 8

Findings and analysis of possible options and considerations

Ex: Procedure specific assessment, vitals, labs, pain rating, sedation level, skin condition

Question 9

SBAR - Recommendation

Answer 9

A discussion about what should happen next

Ex: Update plan of care, notify physician, medication adjustments

Question 10

What is the optional second “R” in SBAR

Answer 10

Readback/ Repeat

Question 11

Benefits of SBAR

Answer 11

1. Allows nurses to spend less time writing which increases amount of time focused on patient care
2. Reduces risk of adverse events
3. Increases communication amongst nursing staff

Question 12

Near Events

Answer 12

Errors in care that should never occur during a procedure due to catastrophic effects on patient safety & outcomes that event could have

Question 13

Examples of Never Events

Answer 13

1. Performing the wrong procedure on a patient
2. Failing to consider patient allergies
3. Development of pressure ulcers
4. Any adverse outcomes

Question 14

Costs associated with never events

Answer 14

time, labor, money

Question 15

What is the purpose of the WHO’s surgical safety checklist?

Answer 15

Provides a standardized list of actions that should be done to keep surgical patients safe

Question 16

What is the purpose of an intraoperative report?

Answer 16

Permanent part of the patient record that serves as a baseline of care coordination and communication

Question 17

What are the primary benefits of perioperative checklists?

Answer 17

1. Validates the execution of processes and procedures
2. Essential pathways for communication among multiple disciplines
3. Enables professionals to adhere to standards and identify trends that can impact care

Question 18

What must be true about checklists to be effective?

Answer 18

Everyone must use them

Question 19

Benefits associated with using standardized communication tool

Answer 19

Improved quality of care, improved patient outcomes, improved patient satisfaction

Question 20

3 primary components of 1996 HIPAA

Answer 20

1. Keep health records confidential & secure
2. Allow individuals to conditionally keep employer sponsored health insurance for a certain period if they leave
3. Standardize electronic processes relating to healthcare services

Question 21

Goals of standardized communication tools

Answer 21

Reduces variability in communication, reduces incomplete/ partial communication, prevents irrelevant communication

Question 22

Primary focus of CDC

Answer 22

Public health initiatives and best practices

Question 23

A teaching hospital experienced 3 errors over 4 months that were caused directly by first year residents. The hospital reports these errors even though they are not required to. What legal act do these actions fall?

Answer 23

PSQIA
Patient Safety & Quality Improvement Act – allows organizations to self-report errors without being subject to HIPAA violations (all patient info is confidential)

Question 24

When is the best time to raise concerns about a procedure that a patient has undergone?

Answer 24

Before, during, and after the procedure